The factor structure of self-reported physical stress reactions

A self-report questionnaire tapping 98 frequently reported physical stress reactions was subjected to factor analysis. The instrument was given to 1,210 subjects (593 males, 520 females, and 97 who failed to indicate their gender). The final factor solution identified 18 interpretable factors for the combined sample. Some of the more notable findings are: (a) Gastric Distress (Factor 1) is by far the most prominent factor and accounts for .491 of the total variance; (b) the factor solutions for males and females are highly similar, although Cardiorespiratory Activity (Factor 2) is defined by a greater diversity of noncardiac reactions for females than for males; and (c) six independent striated muscle tension factors can be identified for the entire sample. Results are discussed in terms of a behavioral conceptualization of psychosomatic symptoms. Clinical implications are noted.     

Treatment with physical therapy after knee injuries]

Trauma to the inner knee disturb the organism's local and central regulations. Physiotherapeutic measures stimulate self-regulatory and self-regenerative mechanisms of the organism. Depending on the specific needs of the patient, active exercise treatment, or various procedures of physical therapy are administered (hydro and thermotherapy, electromedicine, light therapy, aerosol therapy, balneology, and climatology) in order to achieve his/her full restoration to the maximal potential vocationally, socially, and physically.     

A retrospective study of changes in physical symptoms and body image after reduction mammaplasty

Reduction mammaplasty is performed typically to alleviate the painful physical symptoms of macromastia. Women who suffer from macromastia also frequently present to the plastic surgeon with heightened body image dissatisfaction and maladaptive behavioral changes in response to their breast size. Numerous investigations have demonstrated improvement in physical symptoms after breast reduction surgery. Studies have also suggested that psychological improvement occurs postoperatively; however, they have not used well-validated, standardized psychological measures. The present study is a retrospective analysis of the physical and psychological status of women who underwent reduction mammaplasty. One hundred ten patients who underwent a reduction mammaplasty between 1982 and 1996 were mailed a packet of questionnaires designed to assess current physical symptoms and body image. Sixty-one of the 110 patients (55 percent) responded. The vast majority reported substantial improvement or elimination of neck, back, shoulder, and breast pain, grooving from bra straps, poor posture, skin irritation, and social embarrassment. In addition, they reported significantly less dissatisfaction with their breasts as compared with a sample of breast reduction patients assessed preoperatively. Symptom relief and improved body image occurred independently of preoperative body weight, as we found few significant differences between obese and non-obese women concerning the resolution of physical symptoms or improvement in body image. Results provide further evidence of the efficacy of reduction mammaplasty not only for relief of physical symptoms but also for alleviation of body image dissatisfaction.     

Hospital intensive monitoring of adverse reactions of ACE inhibitors

BACKGROUND AND AIMS: Angiotensin II converting enzyme (ACE) inhibitors represent one of the most important pharmacological instruments for the treatment of arterial hypertension and are currently also used for other cardiovascular indications. The actions of ACE-inhibitors mainly depends on blocking the ACE enzyme in the renin-angiotensin-aldosterone system. However, the ACE enzyme also has a kinase activity. The inhibition of this enzyme may also cause an accumulation of tissue mediators (bradykinin) responsible for a number of adverse reactions. METHODS: An intensive hospital monitoring programme of adverse reactions to drugs, known as MIO[symbol: see text]'96, was carried out by the Centre of Pharmacoepidemiology of the Faculty of Medicine and Surgery at the Second University of Naples during the period 25 March-18 April 1996. The main aims of the programme were to highlight the incidence of adverse reactions to the drugs monitored and the definition of the risk/benefit ratio taking account of the main physiological and pathophysiological variations of patients. This paper reports the results of the programme of adverse effects correlated to the use of ACE-inhibitors. A total of 175 records were compiled for 105 patients receiving antihypertensive treatment with a number of ACE-inhibitors (captopril, enalapril, lisinopril); a very high mean incidence of adverse events was documented (22%) without any severe undesirable effects. RESULTS: The following adverse events were documented (the cumulative incidence is given in brackets): dysgeusia (17%), flush (8%), headache (33%), exanthema (17%), diarrhoea (8%), vertigo (8%), xerostomia (8%). Coughing was not reported in any patient. CONCLUSIONS: Further periods of intensive monitoring will be required to obtain a greater quantity of data from the Intensive Monitoring of adverse events through the MIO[symbol: see text]'97 programme.     

The functional organization of the adaptive and compensatory reactions of the endocrine glands

Current concepts of the systemic organization and interrelationship between adaptive and compensatory responses of the endocrine glands and hormone-producing cells are reviewed. Emphasis is made on the involvement of prolactin, insulin endorphins and other neuropeptides into stress responses. A problem of the multihormonal control of physiological functions and role of blood protein carriers and hormonal cytoreceptors in pathogenesis of various diseases are discussed. Special attention is paid to the importance of endocrine function reserves testing for diagnosis of premorbid states and for estimation of human psychophysiological and physical potentials.     

The adaptive reactions of the cardiorespiratory system in chronic bronchitis and its premorbid forms

AIM: Investigation of pulmonary ventilation, blood flow and cardiodynamics in subjects at risk of chronic nonspecific pulmonary disease (CNPD), prebronchitis (PB) and chronic bronchitis (CB). MATERIALS AND METHODS: 118 workers exposed to toxico-chemical factors underwent zonal rheography. RESULTS: At early stages of CB marked disorders of pulmonary ventilation and blood flow in the lungs were revealed. These disorders in subjects with threatened CNPD were regional and accompanied by a moderate increase in power inputs of the cardiorespiratory system. The maintenance of adequate pulmonary exchange in patients with PB entailed functional tension of the respiratory and cardiovascular systems that contributed to decompensation of adaptive mechanisms and occasionally to development of rheographic signs of pneumosclerosis in the lung zones with damaged ventilation and low perfusion of the pulmonary vessels. CONCLUSION: Overloading and decompensation of respiratory and cardial mechanisms of gas exchange regulation in the lungs in response to external damage may lead to development of myocardiodystrophy and pneumosclerosis which appear to be the "price of adaptation".     

The status of neurologic intensive care in Germany. Current data]

In 1994 this journal published the results of a survey undertaken on behalf of the Working Association for Neurological Intensive Care Medicine (ANIM) in the winter of 1992/93. In the winter of 1996/97 a continuation of this analysis was performed. With the help of a questionnaire the data of 62 intensive care units with a total of 420 beds were established. This is 11 intensive care units and 83 beds more than 1992/93. The intensive care units were again classified into three groups (ventilation units, monitoring units, interdisciplinary units) relating to their equipment and structure. The questions concerned structural organisation, such as the number of beds, type of clinic, number and training of physicians and nurses, technical equipment and availability of large and high-tech apparatus or access to other facilities, such as neurosurgery. Of great interest were data about whether and to what extent special measures of intensive medicine can be taken on the one hand and performance parameter data e.g. days of ventilation and duration of in-patient treatment on the other hand. Detailed data were provided concerning the frequency of each diagnosis of patients treated in those intensive care units. Evaluating the data a positive development in the last four years of the neurological intensive care can be found in most of the areas investigated. It has also been found that neurological intensive care in the new lander has reached equal standard both in quality and quantity. Now a single physician is responsible for 2,3 beds compared to 3,6. Today 78 per cent of the beds in ventilation units are equipped with a ventilator. The overall time of ventilation increased to 48 per cent. Overall there are, however, considerable differences between individual units as well as regions. The data presented can serve as a means to monitor the quality of neurological intensive care.     

Quality of life after intensive care

The outcome of intensive care is related to patient selection and case-mix. Especially when assessing QOL, the results should be interpreted in the context of age and the cause of intensive care admission. Only a few QOL studies so far have databases which are large enough to characterize the outcome in specific patient groups. The influence of preexisting chronic diseases should be taken into account as well. A far more difficult issue is how to screen for differences in socioeconomic background. Problems in physical functioning seem to be common among ICU patients in general, but among younger patients the psychosocial problems are also dominant. While the QOL after intensive care as compared with reference values may be better perceived among older patients, the previously healthy and younger ones tend to experience more limitations. The reason for intensive care presumably has impact on the pattern of convalescence. A better understanding of the natural history of recovery from critical illness may help to identify those patients who need more intensive rehabilitation.     

The development of a course in basic physical examination skills

Basic clinical skills of most medical school undergraduates continue unobserved and deficiencies have been detected in a significant number of physicians during residency. Nevertheless, our health care system is calling for competent graduates with solid basic clinical skills and a larger representation of qualified generalists in the increasingly important managed care environment. The need for a better introduction to Clinical Skills course was identified by students and clinical faculty at Ponce School of Medicine. In response to these concerns a new curriculum was developed with clear objectives, effective instructional strategies, and performance-based evaluation, with adult learning principles as its framework. The musculoskeletal examination unit of the curriculum was pilot tested and the course evaluation strategies revealed satisfaction with objectives, instructional and evaluation strategies, as well as improved confidence, and sense of usefulness for the learned skills. A curriculum in basic clinical skills that incorporates adult learning principles with solid instructional strategies can increase the confidence and skills of the learners and should lead to improved outcomes.     

The law of human body disposal and organ transplants]

OBJECTIVE: To review the diagnoses after 5 years in patients who were identified within 12 months of the onset of well established and undifferentiated connective tissue diseases (CTD); to examine death rates and disease remissions in these patients. METHODS: This inception cohort of 410 patients was identified in 10 academic rheumatology practices. They had less than one year of signs and/or symptoms of CTD. Diagnoses of specific well established CTD were made using accepted diagnostic and classification criteria. The diagnoses after 5 years were determined. RESULTS: Patients with well established CTD tended to remain with the original diagnosis. The progression of unexplained polyarthritis to rheumatoid arthritis occurred infrequently. Ten percent of patients with isolated Raynaud's phenomenon progressed to systemic sclerosis (SSc). The 5 year survival was over 90% in all diagnostic categories, with the exception of SSc, in which it was 64%. CONCLUSION: Patients with a well established CTD usually continued with the same diagnosis. Patients with undifferentiated CTD tended to remain undifferentiated or to remit.     

Lipoprotein profile determinants in children and adolescents from a lipid consultation clinic. The impact of diet, body composition and physical activity]

The production of extracellular beta-amylase by some Bacillus cereus, Bacillus megaterium and Bacillus polymyxa [corrected] strains was investigated, and the maximal yields of the enzyme were 3.6; 9.3 and 20.4 U/mL of the culture fluid, respectively (U, 1 mumol of maltose equivalent per min at 30 degrees C). Several cultivation media were used for beta-amylase production. Bacillus cereus and some strains of Bacillus megaterium gave good yields of beta-amylase only in medium with the addition of nutrient broth. However, beta-amylase produced during growth in protein rich medium (nutrient broth) was highly unstable, probably due to inactivation by proteolytic enzymes co-existing in the culture fluid. Bacillus polymyxa [corrected] strains can produce good yields of beta-amylase on a semi-synthetic medium consisting of inorganic salts, potato starch and inexpensive soybean extract instead of costly peptone and meat extract. The most potential beta-amylase producer was the strain Bacillus polymyxa [corrected] NCIB 8524. The tested Bacillus megaterium and Bacillus polymyxa [corrected] strains were apparently differentiated by temperature cultivation (30 and 37 degrees C) suitable for beta-amylase amylase yield.     

Amphetamine's effects on food consumption and body weight: The role of adaptive processes.

Three experiments were conducted to characterize the time course of amphetamine's effects on food consumption using procedures that would allow both decreases and increases in eating to be evident relative to control levels. In Experiment 1 we measured eating over 12 postinjection hr in rats. Orderly changes in within-day temporal patterns of eating over the 12 days of amphetamine administration suggest the role of conditioned adaptive processes. In Experiment 2, animals were not presented food until 2 hr after drug administration. Initial anorexia and subsequent hyperphagia were produced by repeated administration of amphetamine. Experiment 3 assessed both within-day and over-day changes in body weight and food consumption and showed that in addition to the drug's anorectic effect, amphetamine also reduces body weight via other mechanisms. In interpreting tolerance to anorectic drugs, it is necessary to evaluate such changes in body weight that indicate shifts in hunger that occur over days as well as shifts in within-day temporal patterns of eating that indicate the presence of conditioned adaptive changes. It is proposed that these two adaptive mechanisms account for pharmacodynamic tolerance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tingible body macrophages in regulation of germinal center reactions

Tingible body macrophages (TBM), long thought simply as scavengers of apoptotic lymphocytes, are located in the unique microenvironment of germinal centers in close proximity to antigen-retaining follicular dendritic cells (FDC). Observations that TBM endocytose FDC-iccosomal (immune-complex coated bodies) antigen suggested that TBM might present this antigen and help regulate the germinal center reaction. To test for antigen presentation, the ovalbumin (OVA)-specific T(H) hybridoma, 3DO-54.8, which produces IL-2 on receiving effective presentation of OVA, were used as responders to OVA-bearing TBM. Results showed that OVA-bearing TBM failed to induce IL-2 production. Furthermore, addition of TBM to IL-2-inducing positive controls (B cells) not only failed to augment IL-2 production, but rather TBM significantly (55-90%) reduced B-cell induction of IL-2. We found that TBM were rich in prostaglandin by comparison with other nongerminal center lymph node macrophages and that addition of indomethacin to the cultures reversed the inhibitory effect of TBM. Depletion of TBM from enriched preparations, prior to addition to positive control cultures, also abrogated the inhibitory effect on IL-2 production. These data support the concept that TBM, within the unique microenvironment of germinal centers, may be specialized to downregulate the germinal center reaction.